Cervical necrotizing fasciitis is a fast spreading acute soft tissue inflammation. Death can occur within 12–24 h. Early identification and treatment is needed. Citation: Lambade PN, Dolas RS, Virani N, Lambade DP () Cervicofacial Necrotising Fasciitis of Odontogenic Origin: A Review. Necrotizing fascitis is rapidly spreading soft tissue infection involving the subcutaneous tissues. Cervicofacial necrotizing fasciitis (CNF) is rare complication from.

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Within the genus, most of the species of clinical significance belong to the genetically closely related genomic species 2 y Acinetobacter baumannii3, and 13 sensu Tjernberg and Ursing 13TU.

Minor trauma triggering cervicofacial necrotizing fasciitis from odontogenic abscess

This creates an acidic, oxygen-deficient environment for the proliferation of bacteria. Streptococcus species produce M proteinwhich acts as superantigenthus stimulating a massive systemic immune response, which is not effective against the bacterial antigen, precipitating shock.

There are only few reports of Acinetobacter being grown on culture in NF. necrotizinh

Jpn J Oral Maxillofac Surg. One case cervicpfacial growth of Acinetobacter in the series reported by Panda et al. In our case, the pathogen may have been inoculated by the patient by the application of herbal leaves contaminated with Acinetobacter. The two toxins together can cause destruction of red blood cells in blood vesselsdamage to the integrity of the blood vessels, and suppression of heart function.

Journal of the American College of Surgeons. Wound carehandwashing [3]. Textbook of Family Medicine. While studies have compared moxifloxacin a fluoroquinolone and amoxicillin-clavulanate a penicillin and evaluated appropriate duration of treatment varying from 7 to 21 daysno definitive conclusions on the efficacy of treatment, ideal duration of treatment, or the adverse effects could be made due to poor-quality evidence.

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Necrotizing fasciitis Role of early surgical intervention. Get free access to newly published articles. The initial skin changes are similar to cellulitis or abscessthus making the diagnosis at early stages difficult.

Cervico-facial necrotizing fasciitis.

Those with clostridial infections typically have severe pain at the wound site, where the wound typically drains foul-smelling blood mixed with serum serosanguinous discharge. Type III infection – Vibrio vulnificusa bacterium found in saltwateris a rare cause of this infection, which occurs through a break in the skin. C-reactive proteintotal white blood cell count, hemoglobinsodiumcreatinineand blood glucose. Footnotes Source of Support: A tool for distinguishing necrotizing fasciitis from other soft tissue infections”.

Prostaglandin has been responsible for fever, inflammation, and pain. After the wound debridement, adequate dressings should be applied to prevent exposure of bones, tendonsand cartilages so that such structures do not dry out and to promote wound healing. The raw areas contracted and multiple strips of split-thickness skin grafts were taken from the lateral thigh and grafted on to the areas left exposed by the surgical debridements.

Hence the need to create awareness among rural and tribal populations on cerviofacial danger of inflicting such trauma as a remedy for odontogenic abscesses. Early diagnosis is difficult, as the disease often looks early on like a simple superficial skin infection. The inhibition of prostangladin E2 production reduces inflammatory response and leukocyte adhesion, and thus reduces immune response against bacterial invasion, giving rise to soft-tissue infection.

Necrotizing fasciitis

Symptoms may include fever, swelling, and complaint of excessive pain. Some skin over the face and neck underwent necrosis, with the formation of cervicofwcial yellowish slough and discharge of pus externally and intraorally.

Early recognition and aggressive treatment of cervicofacial fasciitis can arrest its rapid progression and prevent devastating sequelae. Necrotizing changes affecting the groin are known as Fournier gangrene.


Traditionally, empiric antibiotics are initiated as soon as the diagnosis of NSTI has been made and then later changed to culture-guided antibiotic therapy. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more.

When in doubt, a small incision can be made into the affected tissue, and if a finger easily separates the tissue along the fascial plane, the diagnosis is confirmed and an extensive debridement should be performed.

A year-old male presented to the otolaryngology department of our hospital with a day history of generalized dental pain and bilateral facial swelling, pain, trismus, and fever; these symptoms had begun 1 week after a toothache. Extensive debridement of all necrotic tissue is the most important part of treatment in these patients. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account.

Acinetobacter should be considered as a possible pathogen in patients with NF and care should be taken to select antibiotics that are active against this organism.

Exploration and decompression of all involved fascial spaces was done. Various scoring systems are being developed to determine the likelihood of getting necrotizing fasciitis, but a scoring system developed by Wong and colleagues in is the most commonly used.

Therefore, the values derived from this scoring system should be interpreted with caution. We review the case in detail and discuss clinical and radiological clues to diagnosis, surgical and medical management, wound care, and subsequent scar contracture. Author information Article notes Copyright and License information Disclaimer.